Scaling Global Healthcare: How MiracleFeet Automated 800,000 Patient Visits Across 37 Countries

Every year, up to 200,000 children are born with clubfoot, a treatable condition that, without intervention, can lead to lifelong disability. MiracleFeet, a global health organization working in 37 countries, is on a mission to ensure every child has access to quality clubfoot treatment, regardless of where they're born.

But here’s the challenge: delivering clubfoot treatment at scale means coordinating care for thousands of children across more than 500 clinics, each child returning many times over several years for casting, bracing, and follow-up appointments. This process generates massive amounts of data.
How do you track 800,000 annual patient visits, ensure treatment quality, and support healthcare workers in real-time without drowning in spreadsheets and manual data entry?

For MiracleFeet, the answer was workflow automation.

The Challenge

Since 2016, MiracleFeet has relied on CAST, a powerful mobile application built on the CommCare platform, to help clinics track patient data. The app is available in English, French, and Spanish. CommCare was chosen for its robust offline-first capabilities (critical for clinics with unreliable internet) and its ability to handle complex, multi-year case management logic. This enables healthcare workers to not only track patient data but also receive decision support and manage the full treatment journey directly from their mobile devices.

"The success of this entire pipeline starts with good data. CommCare has been a foundational partner for us since 2016. The platform's reliability and powerful offline-first case management are critical. Knowing we have a robust, high-performance tool at the point of care in 500+ clinics is what makes this automated system so impactful in the first place." - Clifford Hakimi, MiracleFeet's Associate Director of Digital Systems and technical lead.

While healthcare workers in the field could record treatment details, the organization faced a new scalability challenge: how to connect this rich, field-level patient data from CommCare with their central Salesforce M&E system. Without a direct integration, program data remained siloed by default, making it difficult to generate reports, monitor key performance indicators, or gain real-time insights into program performance.

With ambitious goals to reach 17,000+ new children annually, and with each child requiring treatment for up to five years, MiracleFeet needed a solution that could scale without requiring a complete technical infrastructure overhaul.

The Solution: Automated Data Integration

In partnership with Vera Solutions and OpenFn, MiracleFeet built an automated data pipeline connecting field-level mobile apps to their centralized Salesforce monitoring and evaluation system.

Here's how it works:

When a healthcare worker records a patient visit in CommCare, OpenFn automatically syncs that data to Salesforce. This happens in real-time, without any manual data entry. Patient records, treatment progress, appointment schedules, and outcome data flow from 500+ clinics into a unified system where MiracleFeet's team can track performance, identify issues, and make data-driven decisions. MiracleFeet not only provides organizational, technical, and financial support to clinics to increase access to treatment for children born with clubfoot in low- and middle-income countries. Therefore, real-time access to patient data enables them to regularly and rapidly deliver better health outcomes.

The organization also implemented automated SMS reminders through Infobip in some clinics to help families stay on track with treatment adherence and clinic appointments, particularly critical during the intensive first two months when visits are most frequent.

The Impact: Quantifying Time and Cost Savings

The numbers tell a powerful story. With 800,000 patient visits recorded annually across nearly 40 countries, manual data management and accurate program monitoring would not just be challenging but essentially impossible at this scale.

MiracleFeet uses OpenFn's ROI calculator to estimate the value of their three core automated workflows. The calculator measures the cost of performing each workflow manually (in staff time and dollars) versus running it on OpenFn.

At 800,000 patient visits a year across 500+ clinics, this isn't just time saved - it's what makes accurate, real-time program monitoring possible at all. Without automation, the scale of MiracleFeet's work simply couldn't be managed.

According to Clifford Hakimi, "Without OpenFn or a similar platform, we would have had to build and maintain our own custom-coded integration to connect CommCare and Salesforce. That would have been slow, clunky and extremely demanding on our team, with significant room for errors. OpenFn lets us leverage the powerful APIs of both systems without having to become integration developers ourselves."

Beyond direct time savings, the automation has enabled MiracleFeet to maintain a lean technical infrastructure. "OpenFn allows us to stay on a SaaS model, so we don't need a dedicated developer," Cliff explains. "That eliminates the high cost of specialized technical staff and the knowledge gaps that come with team turnover."

Real-Time Data for Better Patient Outcomes

The ability to access centralized, real-time data has transformed how MiracleFeet supports healthcare workers and monitors treatment quality. The organization can now track patient progress from the individual level all the way up to strategic decision-making, identifying patterns and intervening when clinics need additional support.

Anna Cuthel, MiracleFeet’s Technical Director, had this to say about the advantage of having real-time data:

“MiracleFeet regularly uses real time data to catch emerging treatment problems, such as when a child has undergone a lengthy period of casting beyond recommended limits, and requires a more senior Orthopedic surgeon review.”

“Analyzing field data helps MiracleFeet to pick up structural treatment challenges to be solved. For example, a clinic's low tenotomy rate has highlighted where a tenotomist has rotated away from a clinic, leaving a critical gap in human resources.” - Anna Cuthel

With automated SMS reminders helping families stay on track with appointments, particularly during the critical early treatment phase, MiracleFeet has seen measurable improvements in treatment adherence.

Scaling for the Future

As MiracleFeet continues to expand, reaching more children across more countries, the automated infrastructure provides the foundation for sustainable growth. The organization has scaled from 180 clinics since the launch of CAST to over 500 today, all while maintaining data quality and real-time visibility.

"The support from the OpenFn core team has been exceptional," Cliff notes. "They're incredibly responsive and don't just point out what's wrong. They actively troubleshoot with us and even warn us about potential issues in advance."

What This Means for Global Health Organizations

MiracleFeet's success demonstrates what's possible when global health organizations embrace workflow automation and system integration. By integrating best-in-class platforms like CommCare for point-of-care case management and Salesforce for centralized M&E organizations can:

• Scale operations without proportionally scaling administrative staff
• Maintain data quality while handling massive volumes of information
• Respond to field issues in real-time rather than discovering problems weeks or months later
• Free healthcare workers and program staff to focus on patient care rather than paperwork

Get Started

If your organization is managing data across multiple systems and countries, workflow automation can unlock the scale and efficiency you need to maximize your impact.

OpenFn offers 80+ pre-built adaptors for platforms like Salesforce, CommCare, DHIS2, and more, and can connect to any app or legacy information system. Whether you're tracking patient care, managing grant portfolios, or coordinating services across multiple partners, automated workflows eliminate manual data entry and give you real-time visibility into your programs.

Ready to scale your impact?

This solution stack highlights three key partners. See how each piece can help your organization:

To connect your systems and automate workflows, learn more from OpenFn:

• Sign up for free at app.openfn.org
• Explore our documentation at docs.openfn.org
• Speak to our services team - support@openfn.org - that have worked with over 75 governments, NGOs and SMEs worldwide.

To build a powerful, offline-first data collection and case management app like CAST, learn more from CommCare:

• Book a demo https://dimagi.com/commcare/
• Get started for free at https://www.commcarehq.org/

To learn more about the mission to end clubfoot and support this work, visit MiracleFeet: www.miraclefeet.org